Diabetes, specifically type 2 diabetes is growing at an alarming rate according to statistics published by the U.S. Department of Health and Human Services (National Diabetes Statistics, 2011 – National Diabetes Information). The American Diabetes Association (ADA) has described type 2 diabetes as “the new epidemic in the American pediatric population.” There has been a 33 percent increase in type 2 diabetes cases diagnosed in the U.S. in the past decade. Back in the 1990s, it was extremely rare to diagnose new cases of pediatric diabetes but by the year 2000, it accounted for 8-45 percent of new cases depending on geographic location.
New cases of type 2 diabetes occur mainly in African-American, Mexican-American, Native American and Asian-American children and young adults. As found with the adult population, insulin resistance and relative beta cell failure are the origin of the disease process. While there appears to be a host of potential genetic and environmental risk factors for insulin resistance and limited beta cell reserve, the most significant risk factors are obesity and genetics.
In 2011, the total prevalence of diabetes was 25.8 million, about 8.5 percent of the United States population. 27 percent of the baby boomer generation or about 11 million people have been diagnosed with type 2 diabetes. It is estimated that as many as 80 million people are currently classified as “pre-diabetic” and it’s estimated that a majority of these people will progress to a definitive diagnosis. These statistics have many experts concerned about the burden of cost on the healthcare system. In 2013, the cost of treating type 2 diabetes was $245 billion.
The growing number of diabetes patients will also create a cascade effect on other parts of our healthcare delivery system. For example, diabetes is the leading cause of kidney failure accounting for 44 percent of all hemodialysis patients. In 2008 there were 202,290 people with end stage kidney disease due to diabetes living on chronic dialysis.
If 30 million citizens have diabetes and perhaps three times that number – about 80 million – are on their way to diagnosis and 44 percent of all dialysis patients have diabetes – we can logically project that there will a much higher demand for dialysis centers throughout the U.S. Now that we know we have three generations racing towards type 2 diabetes, there will probably be a shortage of these types of treatment centers – especially in areas with a heavy concentration of ethnicities that are more susceptible to the disease.
With so many more patients to manage and a potential shortage of facilities, how will the healthcare industry respond? Dialysis centers could become a major part of hospital consolidation or they could be purchased by corporate entities such as Fresenius or DaVita? It’s possible that endocrinologists and nephrologists will see this as an opportunity and begin to acquire outpatient facilities and offer dialysis as an extension of their practices. It remains to be seen whether there will be a trend towards outpatient or inpatient care.
The dramatic increase in diabetes patients will also create new challenges in professional liability for healthcare facilities and professionals treating these patients. Dialysis centers present unique challenges related to risk: potential for infectious disease, (tuberculosis, and nosocomial infections); soft tissue infections; medication errors; pollution exposures; slips and falls; and equipment failure to name a few. So there will be much higher demand for quality professional liability insurance in this segment of the healthcare field. Are dialysis centers the next opportunity for the many talented program administrators in the Insurance industry? Stay tuned, the trends will take shape very soon.